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HomeMy WebLinkAboutFischetti ,'4.,, 1CeOLcze S JUDITH T. TERRY ,r41 Town Hall, 53095 Main Road � � Southold New York 11971 P.O. Box 1179 TOWN CLERK � � ‘�, �� � REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER � V � •� Fax (516) 765-1823 ` �'�,+ Telephone (516) 765-1801 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 1671-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner FISCHETTI, LINDA Mailing Address 1 1725 HOBART ROAD Mailing Address 2 City St Zip SOUTHOLD NY 11971-0000 Property Address 1 1725 HOBART ROAD Property Address 2 City St Zip SOUTHOLD NY 11971-0000 Owner Telephone No. 516-765-5776 Tax Map No. section 64.00 block 2 lot 14.000 Cross Street LONDON COURT Date Of Last Pump Out 0/00/00 Issue Date: 4/22/91 Judith T. Terry Southold Town Clerk (TOWN SEAL) • OFFICE OF THE TOWN CLERK \\MU(��= Town of Southold �� :�.-. CQG'_ Application No. /6 /�y` Judith T. Terry, Town Clerk . . Town Hall, 53095 Main Road ? a-w `j. s:� -4 $10.00 - Residential j:� P. O. Box 1179 u' �,r. ' <4-"'t ���;, $25.00 - Non-Residential _ Southold, New York 11971 O Telephone *1 (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION . for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ DATE it) ZZ) 9J OWNER NAME: / -sche 7. OWNER MAILING ADDRESS: LI M d4 f1sClurM 172,6— / avi- Poraj , S u4 ! 1, I'llY OWNER PROPERTY ADDRESS: ( #vYi&Q\ OWNER TELEPHONE NUMBER: (676, ) 65- - 6-77 TAX MAP NO. : Section 61' Block Lot CROSS STREET: LEO Cerva TYPE OF SYSTEM: Septic Tank New Existing Cesspool 2 New Existing 1/- Residential /Residential 1. Non-Residential DATE OF PREVIOUS PUMP-OUT: /'/rel Z ,?9 / LOCATION MAP: Must be attached hereto before permit may be issued. (Locate building and system; give north arrow and f=-t of distance, approximately, to building and closest r•\d.) !LIM Atiatilk i• ature of Applicant Zeil b/419- • RECEIVED BY:44,,Lea&. , n'Clerk's Office DATE: APR 2 leg 4 Ton OM 1,� i` ' , '° t t . •t7. Vi t • , r.' 71 dYJI II i 4M G 5.i--- I. CI ��g / > /'...„ q di- A. un' ,APi A0 IL. Zai iii I. ' . _ mooQ -,.1 0 . o Ion pi_Ay YARD -,j _ - -----_ • 4 p f Il. _ CoCi1ttlrl,c q, c-.;° - eNCI. ''-til endi', _ Cti s r ,� v H • ,ifI -19 y1'11 " t ss°v11 • +t; z zd° UD 9 2 z w C) "t hr 1 150.0 • • U .Vt=y LTD rc r, ' J05 L.: 1' ,I-1 e LINDA_ r 1�1e: 1 = S 0j J -i 1-i O L.. ID Gl 0/A01,-.11..J/A1.--.1T sb TO\Vh1 Or- SOLJTHOL.17 /NIIyv+.eyC)RB, SUFF. TAX /AAP NO.:1 '.4) 6 o•�t r IC)OO-064-2-14 . t :.O'r f.iU/A F5E-NS -L'PZ TO tt ^AI- OF r--OUNDL-R5, Unauthorized alteration or addition ct72lteasoE-S?�tr ra u f1LE-P') IN TI-It- SUPF-OIC, COIf4TYCLEA4."5 to this r arl-i t:>~• A€5 /Af\ t4 5 3 .. -.. . Education lata. _ -.... _ ._�__�____ Copies al this survey map not bearing ' C-t�!/\t�Rt�O T r -1 C5 fl- s T I T L.E CI t,lh,f�/�IyZ tt the land aurooyota lydkead eeai or : ®mbossard 9 atFt�U nt;+�cen�[f°..ettta� 1 CC:/,1nm1NY !%NB1 TO 'r'Jl gOUTI jO)LO to be a valid truo copy. • l' SA-VI N C-ig Pht..11 I4,. I Guarantees In&c©ted hereon Moll rust SLIIIS\IE'Yr-T) o SE' '. IS, 1985 only to the parson for whom fihosurvey I }f 'F�,4 d �/�,�d ° �J , (�, Is orad.and ore hits behalf to tt t �' I title company,governmental agency and is ! landing Institution lisped hast'cort and z 1 -- to the assignees of the lending l.'tsta- i --- - - - ---- e tutlon Guarantees aro,mt 0rot fera5le� 't L.1 �; 1-NN!) a C �\/ - O to additional Institutions or auksaxlu�ant t el? g:.N'tV0F:T" , sE.\\/ Y011i4, owners. r r ��@. (II.•'-.', i